Patellar tendinosis as an adaptive process: A new hypothesis

Hamilton, B. and Purdam, C. (2004) Patellar tendinosis as an adaptive process: A new hypothesis. British Journal of Sports Medicine, 38 6: 758-761. doi:10.1136/bjsm.2003.005157

Author Hamilton, B.
Purdam, C.
Title Patellar tendinosis as an adaptive process: A new hypothesis
Journal name British Journal of Sports Medicine   Check publisher's open access policy
ISSN 0306-3674
Publication date 2004-12
Sub-type Article (original research)
DOI 10.1136/bjsm.2003.005157
Volume 38
Issue 6
Start page 758
End page 761
Total pages 4
Place of publication Loughborough, U.K.
Publisher British Association of Sport and Medicine
Language eng
Subject 1106 Human Movement and Sports Science
Formatted abstract
Patellar tendinosis (PT), or ‘‘jumper’s knee’’ is a common condition in athletes participating in jumping sports, and is characterised by proximal patellar tendon pain and focal tenderness to palpation. Hypoechoic lesions observed in the proximal patellar tendon associated with the tendinosis are typically described as being a result of degenerative change or ‘‘failed healing’’. We propose a new model for the development of the hypoechoic lesion observed in PT, in which the aetiology is an adaptive response to differential forces within the tendon.

We assessed the clinical, histopathological, and biomechanical literature surrounding the patellar tendon and integrated this with research into the response of tendons to differential forces.

Results and conclusions
We propose that the hypoechoic lesion commonly described in PT is the result of adaptation or partial adaptation of the proximal patellar tendon to a compressive load. We postulate that the biomechanics of the patellar–patellar tendon interface creates this compressive environment. Secondary failure of the surrounding tensile adapted tendon tissue may result in tissue overload and failure, with resultant stimulation of nociceptors. We believe that this ‘‘adaptive model’’ of patellar tendinosis is consistent with the clinical and histological findings.
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Human Movement and Nutrition Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 41 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 31 Mar 2010, 14:53:53 EST by Jon Swabey on behalf of Faculty Of Health Sciences